Which surgeons in a district general hospital should treat patients with carcinoma of the rectum?

There has recently been considerable media and medical interest in the apparent differences of the results of the surgical treatment of colorectal cancer by specialist and non-specialist colorectal surgeons. We have therefore audited and compared the results of the elective treatment of cancers of the rectum and distal sigmoid colon undertaken by two surgeons working in the same hospital, one a general surgeon with a vascular special interest and the other a colorectal specialist. Although our results demonstrate no difference in overall survival, the higher clinical leak rate and higher rate of palliative diversional surgery in the general surgeon's group lends some support to the argument that carcinoma of the rectum should be treated by surgeons with a special interest in colorectal surgery.